Preliminary application of 192 Ir high-dose rate brachytherapy in postoperative recurrent colorectal cancer with intrapulmonary oligometastases

Abstract

Objective \nTo investigate the efficacy and feasibility of 192Ir high-dose rate brachytherapy for recurrent intrapulmonary oligometastasis after colorectal cancer surgery. \n \n \nMethods \nPatients from May 2013 to October 2017 with intrapulmonary oligometastasisafter colorectal cancer surgery in Cangzhou Integrated Traditional Chinese and Western Medicine Hospital were enrolled. A total of 15 lesions were obtained from 10 patients, which were treated with CT-guided high dose rate of 192Ir. The implant needles were inserted into the tumor and were adjusted to appropriate positions under the guidance of CT. Then the images after transplanting were uploaded to the planning system to delineate the target area and the organ at risk volume. Patients underwent a single radiation dose of 20 Gy. \n \n \nResults \nAll 10 patients were successfully treated. Grade 1 adverse events were observed for 30% of patients. Of the 10 patients, one patient had a mild cough, and two had bloody sputum. There was no serious adverse events occurred. The local control rate (LC) of the patients at 1 year after treatment was achieved in 93.3%. Only one developed local advancement after six months, who received the secondary brachytherapy. The median progression-free survival(PFS) was 8.5 months and the median overall survival(OS) was 14.7 months. \n \n \nConclusions \nHigh dose rate brachytherapy is effective in terms of recurrent lung metastases after surgery for colorectal cancer, with a moderate rate of adverse reactions and a favorable local tumor control rate. \n \n \nKey words: \nColorectal cancer;\xa0Lung metastasis;\xa0High dose ratebrachytherapy;\xa0192Ir